CAJ | 학술논문

目的：探讨可弯曲内科胸腔镜治疗脓胸的临床价值。方法回顾分析34例脓胸行可弯曲内科胸腔镜术辅助治疗疗效,并分层分析其在不同临床分期的疗效及并发症。结果34例患者手术总有效率94．1%(32),有轻中度疼痛、术中均有少量出血,未见其他严重并发症；Ⅰ、Ⅱ、Ⅲ期早期显效分别为100．0%、85．7%和40%,总有效率均为100．0%,Ⅲ期晚期无效。手术次数、手术时间、置管时间、抗生素暴露时间、术后出血量在Ⅰ期与Ⅲ期早期之间均存在统计学差异( P<0．05)；手术时间、抗生素暴露时间在Ⅰ期与Ⅱ期之间存在统计学差异(P<0．05)；手术次数、术后出血量在Ⅱ期与Ⅲ期早期之间存在统计学差异(P<0．05)。结论内科胸腔镜治疗脓胸有效、安全,且手术越早,其创伤越轻,出血越少,手术时间及抗生素暴露时间越短,值得临床推广；Ⅲ期晚期患者不适合内科胸腔镜治疗。
목적：탐토가만곡내과흉강경치료농흉적림상개치。방법회고분석34례농흉행가만곡내과흉강경술보조치료료효,병분층분석기재불동림상분기적료효급병발증。결과34례환자수술총유효솔94．1%(32),유경중도동통、술중균유소량출혈,미견기타엄중병발증；Ⅰ、Ⅱ、Ⅲ기조기현효분별위100．0%、85．7%화40%,총유효솔균위100．0%,Ⅲ기만기무효。수술차수、수술시간、치관시간、항생소폭로시간、술후출혈량재Ⅰ기여Ⅲ기조기지간균존재통계학차이( P<0．05)；수술시간、항생소폭로시간재Ⅰ기여Ⅱ기지간존재통계학차이(P<0．05)；수술차수、술후출혈량재Ⅱ기여Ⅲ기조기지간존재통계학차이(P<0．05)。결론내과흉강경치료농흉유효、안전,차수술월조,기창상월경,출혈월소,수술시간급항생소폭로시간월단,치득림상추엄；Ⅲ기만기환자불괄합내과흉강경치료。
Objective To evaluate the clinical value of medical thoracoscopy on empyema. Methods The clinical data of empyema patients treated with medical thoracoscopy were retrospectively analyzed. The clinical effica-cy and complications in different clinical stages were analyzed. Results The total efficiency of 34 cases was 94. 1%(32). Patents had mild to moderate pain and a small amount of bleeding, without other serious complications. The significant efficiency of stageⅠ, stageⅡand the early period of stageⅢwere 100. 0%, 85. 7% and 40%, respec-tively. The total effective rate for all patients was 100. 0%, but the late period of stage Ⅲ was invalid. There were significant difference in the number and times of operation, the time of catheterization, the exposure time of antibiot-ics and the amount of bleeding after operation between stage Ⅰ and the early period of stage Ⅲ ( P<0. 05 ) . There were significant difference in the time of operation and the exposure time of antibiotics between stageⅠand stageⅡand in the number of operation and the amount of bleeding after operation between stageⅡ and early period of stageⅢ (P<0. 05). Conclusion It is effective and safe to treat empyema by medical thoracoscopy. The earlier the op-eration applies, the lighter trauma is, with less bleeding and shorter time of exposure antibiotics and operation. How-ever, it is not suitable for the late period of stage Ⅲ.